What is erectile dysfunction?
Erectile dysfunction describes a (sober!) man’s inability to get or maintain an erection that’s firm enough for normal sexual intercourse. Normal here means about 3-8 minutes, since the national U.S. average for vaginal intercourse is on the order of 5 ½ minutes. As for severity, the definition of erectile dysfunction has a wide range: it includes infrequent and minor erectile problems as well as complete permanent impotence. In case of the latter, even masturbation then will no longer give a man an erection. Minor erectile problems include for example when older are no longer able to get hard hands-free on a fantasy or thought alone. Another example is an erection that requires a couple of minutes to build up.
Since men often define themselves through their virility and sexual prowess, dealing with erectile dysfunction can be very distressing for them. Particularly so, because they often simplistically believe that intercourse is good sex and good sex is as important to women as it is to them. Of course, women also want a fulfilled sex life, but studies repeatedly have shown that the topic doesn’t rank quite as high as it does for men. Moreover, as you may have experienced yourself, female sexual fulfillment is not critically dependent on having intercourse each time.
To be clear, erectile dysfunction has nothing to do with low libido (sexual desire). Your partner very much wants to have intercourse with you but his penis is simply not living up to the task. That said, your partner can still get a lot of emotional and physical pleasure out of your sexual activities together besides intercourse.
About half of men older than 40 will have difficulties with getting an erection. Depending on each man’s age and health, for some it can be an occasional occurrence of not getting as hard or lasting as long as they’d like to. For others — about 10 percent of men in that age group — it can mean not getting an erection at all. Naturally, such extreme cases are most common among men older than 60.
Even younger men, including teenagers, can experience erectile dysfunction. Studies estimate 20-30% of young men below 40 have at least once experienced a period of erection problems. The underlying causes are different, though.
What causes erectile dysfunction?
For men younger than 40, erectile dysfunction almost always has psychological reasons, such as performance anxiety (when first having sex, the first few times with a new girlfriend, etc.) or a brain overstimulated by excessive porn use. Along the same vein, clinical depression, alcoholism, narcotics abuse, and periods of intense psychological stress can also cause erectile dysfunction in young men. The good thing is that it’s nearly always reversible if the original cause is tackled and/or as the men become more comfortable with sex and their partners.
The causes behind erectile dysfunction in older men are more serious, as they most often are physical health issues that have damaged blood vessels in the penis, thereby preventing blood from accumulating and staying in the penis long enough to give a firm erection. The primary culprit here is high blood pressure that, if chronic over many years, wears out the body’s blood vessel. Obesity, lack of physical exercise, a poor diet, diabetes, smoking and other drugs, but also chronic stress, as well as a wide range of other health issues, can cause high blood pressure.
Low testosterone levels often become a suspect, but they rarely directly cause erectile dysfunction. A lack of testosterone can reduce sexual desire in men but it normally doesn’t impact their erection abilities unless other health issues are involved.
How to turn on a man with erectile dysfunction?
That’s a question many women ask themselves, especially when first experiencing erection problems in their relationships. Many women often are quick to blame themselves, erroneously thinking that they don’t turn on their partners anymore. That’s not the issue at all. As mentioned before, erectile dysfunction doesn’t happen because of low sexual appetite. You partner wants to have sex with you, but he either physically can’t or he’s too afraid he’s going to disappoint you.
First you need to understand what’s causing your man’s erection problems, which — after having read the first section of this article — you by now should have started getting an idea about. If your partner is younger than 40, generally in good health, doesn’t suffer from depression or substance abuse, it’s very likely that he’s just nervous or afraid. You can also judge that by his sexual history. Another cause to check for and rule out is excessive porn use (more than 3-4 hours a week). Even if your new boyfriend currently doesn’t binge watch porn, he may have before he met you and it can take 3 months or longer for the brain to learn how to normally respond to partnered sex again.
Have an open, frank discussion with him and try to make him feel comfortable and confide his concerns and fears in you. Also explain to him what you expect from your sex life and that there’s much more to sex than that five minutes of intercourse. Foreplay and the intimacy of being together can provide equal or even greater pleasure than the intercourse. Try to take his focus away from intercourse and concentrate on the other joys of sex. As intercourse becomes less of a big deal in his mind and as he understands that you can take many other routes to orgasm (oral sex, massages, sex toys, etc.), he’ll view it less as an obligation and more as an option.
If you feel that you can’t handle your partner’s improvement alone, you can also try partner therapy with a professional sex behavior therapist. However, for most young men erectile dysfunction is only a temporary problem and it will eventually go away and not become a life-long issue.
If your partner is older than 40 and it’s clear that his physical health might be behind erectile problems (if you’ve been with your partner for a long time, you’ll easily tell changes in his erection firmness and duration), you first need to figure out what those causes are. Make your partner see a doctor for a full check-up but especially cardiovascular issues. Medication and lifestyle changes may be able to improve his condition and prevent further damage.
However, whatever damage has already been done to penile blood vessels at that point, will be impossible to reverse. Fortunately, there are some medical options that can give firm erections (more on this below). But in order to prevent the issue from becoming a mental one (for example, your partner could start feel inferior and be ashamed in front of you during sex, which then turns into psychological erectile dysfunction) you’ll need to be very supportive and understanding.
Make sex as relaxing as can be for your partner. As explained above for the case of younger men, try shifting the focus away from intercourse and highlight and celebrate the other pleasures sex has to offer. For a man to get an orgasm an erection is not a must — that’s even true for older men. In a relaxed state, a man can get sufficiently aroused to climax even with a flaccid penis.
When to seek erectile dysfunction help and what treatments are there?
If you can rule out mental factors or your partner already has been to therapy but without much success, there are other things you two can try to help him restore his erection.
A popular mechanical solution are vacuum pumps. They consist of a cylinder in which a vacuum is created through a hand- or battery-operated pump, which erects the penis. To hold the erection in place a constriction ring is tightly put around the lower part of the penis. This practice provides about 30 minutes of time during which you can have intercourse.
There also are several effective drugs your partner can take — either ad-hoc up to an hour prior to sex or as a regular daily dose — to get an erection strong enough for sexual intercourse.
The four drugs available in the U.S. market upon prescription are Viagra (sildenafil), Cialis (tadalafil) Stendra (avanafil) and Levitra (vardenafil). They all are taken as oral pills and are sold in both branded and generic versions. Tadalafil is the only one of the three that’s approved for daily long-term use.
All four drugs function in the same way: they increase the penis’ blood supply and thus can give a firm erection, with a success rate of up to 80 percent. But they differ somewhat in their biochemical composition, which affects the onset speed and effectiveness duration. A doctor can tell your partner about these differences and potential side effects of these drugs as well as their interactions with other medications.
- Li, Hongjun, et al. “The Role of the Sexual Partner in Managing Erectile Dysfunction.” Nature Reviews. Urology, vol. 13, no. 3, 2016, pp. 168–77, www.ncbi.nlm.nih.gov/pubmed/26832165, https://doi.org/10.1038/nrurol.2015.315. Accessed 13 Jan. 2020.
- van Anders, Sari M. “Testosterone and Sexual Desire in Healthy Women and Men.” Archives of Sexual Behavior, vol. 41, no. 6, 3 May 2012, pp. 1471–1484, link.springer.com/article/10.1007/s10508-012-9946-2, https://doi.org/10.1007/s10508-012-9946-2. Accessed 13 Jan. 2020.
- Fisher, William A, et al. “Erectile Dysfunction (ED) Is a Shared Sexual Concern of Couples II: Association of Female Partner Characteristics with Male Partner ED Treatment Seeking and Phosphodiesterase Type 5 Inhibitor Utilization.” The Journal of Sexual Medicine, vol. 6, no. 11, 2009, pp. 3111–24, www.ncbi.nlm.nih.gov/pubmed/19674250, https://doi.org/10.1111/j.1743-6109.2009.01432.x. Accessed 13 Jan. 2020.
- Nelson, Christian J. “The Impact of Male Sexual Dysfunction on the Female Partner.” Current Sexual Health Reports, vol. 3, no. 1, Mar. 2006, pp. 37–41, link.springer.com/article/10.1007%2Fs11930-006-0025-3, https://doi.org/10.1007/s11930-006-0025-3. Accessed 28 Nov. 2019.
- Lee, JC, and DHC Surridge. “Erectile Dysfunction: The Perspectives of Patients and Partners on Counselling.” Journal of Sexual & Reproductive Medicine, vol. 02, no. 01, 2002, www.pulsus.com/scholarly-articles/erectile-dysfunction-the-perspectives-of-patients-and-partners-on-counselling.html, https://doi.org/10.4172/1488-5069.1000023. Accessed 13 Jan. 2020.